The Potential to Reduce Falls and Avert Costs by Clinically Managing Fall Risk

Am J Prev Med. 2018 Sep;55(3):290-297. doi: 10.1016/j.amepre.2018.04.035.


Introduction: Falls often cause severe injuries and are one of the most costly health conditions among older adults. Yet, many falls are preventable. The number of preventable medically treated falls and associated costs averted were estimated by applying evidence-based fall interventions in clinical settings.

Methods: A review of peer-reviewed literature was conducted in 2017 using literature published between 1994 and 2017, the authors estimated the prevalence of seven fall risk factors and the effectiveness of seven evidence-based fall interventions. Then authors estimated the number of older adults (aged ≥65 years) who would be eligible to receive one of seven fall interventions (e.g., Tai Chi, Otago, medication management, vitamin D supplementation, expedited first eye cataract surgery, single-vision distance lenses for outdoor activities, and home modifications led by an occupational therapist). Using the reported effectiveness of each intervention, the number of medically treated falls that could be prevented and the associated direct medical costs averted were calculated.

Results: Depending on the size of the eligible population, implementing a single intervention could prevent between 9,563 and 45,164 medically treated falls and avert $94-$442 million in direct medical costs annually. The interventions with the potential to help the greatest number of older adults were those that provided home modification delivered by an occupational therapist (38.2 million), and recommended daily vitamin D supplements (16.7 million).

Conclusions: This report is the first to estimate the number of medically treated falls that could be prevented and the direct medical costs that could be adverted. Preventing falls can benefit older adults substantially by improving their health, independence, and quality of life.

MeSH terms

  • Accidental Falls / prevention & control*
  • Aged
  • Cost Savings / statistics & numerical data*
  • Dietary Supplements
  • Exercise / physiology*
  • Humans
  • Independent Living*
  • Medication Reconciliation
  • Quality of Life*
  • Risk Factors
  • Tai Ji / methods
  • Vitamin D / administration & dosage


  • Vitamin D